Medical Emergencies in a Mental-Health Setting (MEAMS)

AIMS: Medical Emergencies in A Mental Health Setting (MEAMS) was a proposed high-fidelity simulation training course specifically designed for the mental health multidisciplinary team (MDT). A team of resus officers, mental health nurses and psychiatric doctors worked to create scenarios reflecting the emergencies encountered in mental health. It aimed to gives staff simulated experience in approaching and managing a verity of complex emergencies, including physical health, as well as communication scenarios. Specifically the aims were: (1) Determine if course was perceived to benefit staff, (2) Determine if course subjectively increased staff knowledge and confidence in mental health emergencies, (3) Review for continued areas of improvement METHODS: The full day sessions were carried out in the Electroconvulsive therapy (ECT) suite, with it being modified into an immersive environment similar to wards or clinics. The faculty of medical resus officers, mental health nurses and psychiatric consultants ran the courses, with participants joining from across the MDT including nursing staff, junior doctors, consultants, students and nursing assistants. The morning program, run by resus officers, provided education in life support, initial assessment of the unwell patient and intraosseous access. The afternoon contained various scenarios, including for example managing neuroleptic malignant syndrome. Scenarios were observed via video link by faculty, with constructive feedback and debriefs provided. Quantitative data of knowledge and confidence was obtained pre and post sessions using Likert scales. Qualitative information regarding future proposed scenarios, areas of improvement and areas of notable value was gathered. RESULTS: 36 staff attended the program, run over 4 days. Average knowledge and confidence (scored out of 10) improved from 4.9 pre-session to 8.1 post-session. All 36 staff felt the session was beneficial. Particular positive feedback on scenario realism, MDT working, safe/ supportive teaching and the resus faculty teaching was highlighted. Areas for improvement highlighted included running sessions more often, widening accessibility to more staff and teaching on resus medications and fluids. A variety of further scenarios were suggested, for example management of withdrawal seizure. CONCLUSION: MEAMS was felt to achieve its aims, and demonstrated clear subjective increase in staff knowledge and confidence regarding common emergencies seen in mental health settings. Further sessions and wider accessibility to the mental health MDT is anticipated to continually benefit staff. Taking on qualitative feedback, the faculty aims to continually adapt the program to provide the best possible training and education, adapting and creating new relevant scenarios.